1. Field of the Invention
The present invention generally relates to a system and method for determining when an infusion fluid container has emptied, or is about to empty, as a result of fluid being withdrawn from the container. More specifically, the present invention relates to a system including an infusion pump having a sensor that is capable of monitoring and detecting pressure within the container-side of a fluid “infusion set” so as to determine when the associated fluid container is empty, or about to become empty. Upon such detection, the system may provide a local or remote audible and/or visual alert to a caregiver administering or monitoring the infusion and may initiate pre-programmed changes to the flow of fluid including changing to an alternate flow rate or stopping infusion.
2. General Background and State of the Art
Infusion of therapeutic fluids to treat or nourish patients is commonly used in hospitals and other medical care institutions. Originally such infusions were carried out by hanging a bag or container of therapeutic fluid from a pole so that fluid flows under the force of gravity regulated by a user-controllable restrictor through a length of tubing and into the lumen of a vessel of a patient. More recently, the flow of fluid into the patient is under the control of a programmed infusion pump located in the fluid pathway. Infusion pumps are useful in that they allow for more precise control of the flow of therapeutic fluid into the patient. For example, using an infusion pump, relatively precise amounts of fluid may be infused at controlled rates. Moreover, the rate of infusion may be altered during the infusion by programming the pump to pump the fluid at a different rate. This capability is useful where a bolus of therapeutic fluid is desired to initiate an infusion regimen, with the rate then being decreased to a reduced flow rate for the remainder of the infusion. When a pump is located in the fluid pathway, the portion of the tubing between the container of medical fluid and the pump is referred to as the “container-side” fluid line.
One problem that exists with all infusions is that it is difficult to monitor and determine when the fluid container becomes empty, necessitating a change of container or other attention from a care-giver. In the case of a simple primary infusion, when the fluid container is emptied, the flow rate is typically reduced from the flow rate prescribed by a physician to a “keep vein open” or KVO rate. If the empty or nearly empty container is not replaced or replenished, air may enter the infusion line, which is generally considered to be an undesirable condition. In the case of “secondary” infusion, a fluid container containing a different IV solution is attached to the container-side primary fluid line and its fluid is infused temporarily in lieu of the primary fluid until the secondary container is empty. In these infusions attention must be given to the secondary fluid container so that air does not enter into the infusion line.
One method used to monitor the state of the fluid container has been to estimate the volume of fluid in the secondary container and program the secondary mode of the pump to deliver this volume. This method is prone to errors due to mistakes or inaccurate estimations of the fluid infusion rate or the amount of fluid remaining in the container.
In many secondary infusion systems, a one-way check valve is inserted in the primary fluid path and the primary container is lowered below the secondary container, typically, for example, about eight inches. The secondary fluid enters the main intake fluid pathway through a port in the main fluid line. When the secondary container is filled, the pressure exerted against the check valve prevents flow of the primary fluid into the fluid line. When the secondary fluid container is emptied to a level slightly below that of the top of the fluid in the primary container, the pressure against the check valve reduces to the point that it opens, permitting the primary fluid to once again flow into the infusion line.
In many cases where secondary infusion of a fluid is performed, the desired rate of secondary fluid flow is different from the desired rate of primary fluid flow. Accordingly, an operator must preset the infusion pump with the estimated volume in the secondary container, so that when the pump has infused that amount at the prescribed secondary rate, the pump will automatically transition to the primary flow rate. However, frequent errors due to incorrect estimation of container volume or inaccurate setting of the secondary volume-to-be-infused renders this method unreliable, requiring frequent monitoring by care-givers to ensure that the proper fluid is being infused at the proper rate, and to prevent air from entering into the infusion line in the instance of a fault such as a non-flowing checkvalve.
In some infusion tubing setups, there may be multiple infusion lines connected together via a manifold or similar device providing fluid to a common vascular access device. Such a system allows two or more therapeutic fluids to be infused into the patient in a programmed sequence. For example, the care-giver may prescribe a therapeutic regimen requiring the infusion of a primary fluid for a first set length of time, a secondary fluid for a second set length of time, and then a third fluid for a third set length of time, followed by infusion of the secondary fluid. In many cases, the various therapeutic fluids are not compatible with each other, and so care must be taken to avoid mixing the fluids in the manifold. While current pumps can be programmed to deliver the exemplary therapeutic regimen described above, as with the other examples, errors in setting the pumps for the volumes to be infused, or the occurrence of an empty container, can complicate the delivery of the infusion fluids and require frequent monitoring during the infusion.
Another attempt to determine when a container is empty involved trying to sense the vibration produced by drops falling into a drip chamber. Cessation of these vibrations meant that drops were no longer falling, indicating that the container was empty. However, noise sources such as patient or equipment movement, cross coupling between fluid lines or pumping channels made this approach difficult to carry out in practice.
What has been needed, and heretofore unavailable, is an inexpensive yet reliable system and method for detecting when an infusion container is empty, or nearly empty, and for providing a signal to an infusion pump to either alter the infusion rate, provide an alert signal to a care-giver that the container needs replenishment or replacement, or switch to a different infusion source. What is further needed is a reliable system and method for use with automatic secondary infusion setups that provide detection of the occurrence of transition from flow of the secondary fluid to flow of the primary fluid. The present invention satisfies these and other needs.